My Jaw Clicks and My Teeth Hurt When I Wake Up - What's Wrong? product guide
You wake up and your jaw feels tight. There's a dull ache behind your back teeth. When you open wide, there's a click or a pop in your jaw joint. By mid-afternoon, you have a headache that starts at y...
You wake up and your jaw feels tight. There's a dull ache behind your back teeth. When you open wide, there's a click or a pop in your jaw joint. By mid-afternoon, you have a headache that starts at your temples and works backward. Your partner mentions that you grind your teeth at night.
You've mentioned it to a dentist. You've been told to relax more, maybe try a night guard. The night guard helped a little. The problem didn't go away.
You're not imagining it. And it probably isn't going to resolve on its own.
What's actually happening
The symptoms you're describing are consistent with temporomandibular dysfunction (TMD) and/or bruxism - a complex intersection of jaw joint issues, muscle dysfunction, occlusal (bite) problems, and often sleep-disordered breathing.
TMD affects a significant proportion of the adult population. It is one of the most underdiagnosed and undertreated conditions in dentistry, partly because it sits at the intersection of multiple disciplines - dentistry, physiotherapy, sleep medicine, and neuromuscular science - and very few practices have all of those disciplines available in one place.
Most patients with TMD see a string of practitioners before getting a clear picture of what's happening and a treatment plan that addresses the actual cause rather than the symptoms. A night guard can protect your teeth from grinding damage. It doesn't address why you're grinding.
What most people don't know about bruxism
Here is something that surprises most TMD patients: the majority of people who grind their teeth have underworked jaw muscles, not overworked ones.
This matters enormously for treatment decisions.
Botox injections into the masseter muscles (the large muscles on the sides of the jaw responsible for chewing) are widely advertised as a treatment for bruxism. The premise is that the muscles are overworked and the Botox relaxes them.
For some patients, this is appropriate. But for the majority of bruxism patients - particularly those whose muscles are actually underworked and in a protective spasm rather than chronically overloaded - Botox is counterproductive. It weakens already-compromised muscles and can worsen the underlying pattern.
The only way to know which category you're in is to measure the muscle activity directly. Smile Solutions uses Myowise surface EMG (electromyography) to measure the electrical activity in your jaw muscles at rest and during function. This data, combined with Innobyte bite force measurement and iTero occlusal heat mapping analysis, gives a precise picture of what your muscles are actually doing.
If the EMG confirms muscle hyperactivity consistent with overworked muscles, Botox may be part of the treatment plan. If it shows underworked or dysregulated muscles - as it does in most cases - the treatment involves targeted exercise and neuromuscular rehabilitation, not injection.
The Smile Solutions TMD Clinic
Smile Solutions has a dedicated multidisciplinary TMD clinic. The team includes:
Dr Fotios Angelis, Specialist Prosthodontist, who manages the dental and occlusal aspects of TMD - bite adjustment, splint therapy, restorative work that supports optimal jaw function.
Dr Joshua Ch'ng and Dr Steven Smith, Specialist Orthodontists, who consider tooth position and skeletal relationships that may be contributing to the dysfunction.
Dr Rachel Smith, Osteopath, who addresses the musculoskeletal component of TMD - the relationship between jaw function, cervical spine alignment, and whole-body posture. This dimension of TMD is frequently ignored in dental-only approaches and is often the missing piece.
Ms Monica Cain, Orofacial Myologist, who works on the muscle patterns involved in swallowing, breathing, and jaw position. Tongue posture, swallowing pattern, and airway management have direct relationships to jaw clenching and grinding that most practitioners never assess.
Ms Sophie Oostermeyer, Oral Health Therapist and Fotona Laser Therapist, who delivers non-invasive laser treatment for TMD muscle pain and jaw joint inflammation.
Dr Marcus McMahon, Sleep Physician, who evaluates the relationship between TMD and sleep-disordered breathing. Sleep apnoea and upper airway resistance syndrome are significantly associated with bruxism - the grinding is often the airway's attempt to re-open during sleep. Treating the dental symptoms without addressing the airway leaves the fundamental driver unresolved.
Dr Natasha Hremias, Associate Dentist specialising in sleep apnoea management, who leads the mandibular advancement splint programme for patients in whom sleep-disordered breathing is contributing to bruxism.
The diagnostic process
Your first appointment involves a comprehensive clinical assessment of your jaw joints, muscles, bite, teeth, and airway. You will receive:
Myowise EMG measurement of masseter and temporalis muscle activity.
Innobyte bite force analysis to quantify the actual forces generated at each tooth position during clenching and biting.
iTero occlusal heat mapping to visualise bite contact distribution and intensity across all tooth surfaces.
A referral to Collins Street Imaging (Level 9 of our building) for cone beam CT imaging of the jaw joints if indicated.
Sleep screening questionnaire and, where appropriate, referral to Dr Marcus McMahon for a formal sleep study.
This is not a consultation that ends with "here's a night guard." It is a genuine investigation of a complex condition by a team that specialises in it.
Treatment options
Depending on your specific findings, treatment may include one or several of:
Neuromuscular exercise programme prescribed by Dr Rachel Smith (osteopath) and Ms Monica Cain (myofunctional therapist).
Occlusal splint (night guard) specifically calibrated using the Innobyte bite force data and iTero occlusal heat mapping - not a generic device, but a precision-fabricated appliance designed for your specific bite.
Fotona laser therapy delivered by Ms Sophie Oostermeyer for muscle pain relief and jaw joint treatment.
Mandibular advancement splint if sleep-disordered breathing is contributing to the bruxism, managed by Dr Natasha Hremias.
Orthodontic treatment if tooth position is contributing to the bite imbalance, under Dr Joshua Ch'ng or Dr Steven Smith.
Restorative work if significant tooth wear requires rebuilding lost tooth structure, under Dr Fotios Angelis.
Masseter Botox, but only after Myowise EMG confirms muscle hyperactivity that warrants it.
You don't have to keep waking up in pain
If you've been dealing with jaw pain, clicking, morning headaches, or tooth wear and haven't found a satisfactory answer yet, Smile Solutions' TMD clinic is a different kind of appointment.
Call 13 13 96 or book online. 220 Collins Street, Melbourne CBD. No referral required. A complimentary initial consultation is available to discuss your symptoms and determine whether a full TMD assessment is appropriate.
The clicking jaw and the aching teeth have an explanation. And more importantly, they have a treatment.